Demand driven care

In the concept of demand driven care, caregivers give the person empowerment over his life by trying to fulfill the wishes / demands of the person as much as they can. It’s proven that this is a way which satisfies the person – at least on the short term – and may help to avoid conflicts. It’s however the question whether it will bring the person really further in his human development.

 

In gentle teaching we give a special meaning to the concept of demand driven care. We say ‘give the person what he asks, in order to give him what he needs’.

 

We  make a difference between what a person asks for and what he may really need. In the section on quality of life we already described that, whatever the person wants, is somehow related to one or more of the eight basic values of quality of life. It’s his personal expression of the basic values.

It’s like a projector. The lamp is the at the heart of the person. It shines through the basic values and projects the concrete demands on the screen. If the lamp, the heart, is functioning well, the projection will we good. But if the lamp or heart is broken by vulnerabilities and negative life experiences, you may question the quality of the projected images.

 

Demands, as personal expression of the basic values of quality of life, are only meaningful if they are grounded on a meaningful foundation.  According to our vision this means that they should be grounded on meaningful relationships, because being involved in safe and loving relationships is the essence of humanity.  So demand driven care is good, if it’s embedded in an approach which is focused on the basic human need to feel safe and loved.

 

What a person, who doesn’t feel safe and loved and with a broken heart, wants, isn’t always what he really needs. A person who has experienced violence from his caregivers at moments when he lost control over his emotions, he may want to be alone when he feels bad, or he may even want to be alone all of the time. He may want to live in his own room or apartment, without anyone around.  But is this what he really needs?

 

It’s important not just to look at the first impression, but to look deeper. We have to find the real question underneath what he seems to ask for. But don’t look at this from the behavioristic point of view like the stimulus – response sequence.

 

Gerry often is teasing other children when he gets nervous. When he does this, the caregivers always send him to his room where, after some time, he calms down again. If they don’t send him to his room he will get more tensed and at the end he may act with aggression. The caregivers believe that Gerry actually wants to go to his room  when he is nervous, and teasing the other children is his way of asking for this. So they give him what he wants.

 

This kind of linear thinking is not what we do in gentle teaching. We do not interpret his needs from the stimulus - response sequence, but from the perspective our vision on humanity.

We believe that basically every human being needs to feel safe with, and unconditionally loved by others. Especially when he doesn’t feel well or when he feels he isn’t able to deal with whatever he is faced with. At those moments he needs the warm support of others and not the loneliness of his ‘self-chosen isolation’.

 

Gerry needs our presence and warm support when he is emotionally stressed and tends to lose control over his actions. But in order to be able to give him the real support he needs, it’s  necessary that he feels safe with us and unconditionally loved by us. As long as we didn’t achieve that, it’s difficult to help him when he gets nervous.  So for the time being, we may give him want he seems to ask for; going to his room. But we try to stay with him and use the opportunity of the one to one contact to teach him that also in this moment of stress, we are there to help him.

 

Many conflicts between caregivers and special persons are for the three C’s: coffee, cola and cigarettes.  If a person want ‘too much’ of that, it’s put on ration.  The person may only have two coffees, two cola, four cigarettes a day, etc.  Also if the person wants a lot of attention, he can’t get it, because we say he is just ‘looking for attention’.

 

Especially when the person reacts in an obsessive way if he doesn’t get what he wants, we start making plans to control his ‘obsessive behaviors’ and we go from one conflict to the other.

In gentle teaching we see these kinds of ‘obsessive behaviors’ as an expression of the deep need of feeling safe and loved and of being engaged in a warm relationship. The emptiness, which comes out of the loneliness, is filled up with coffee, cola and cigarettes and the never ending search for attention.

 

So we first give the person what he wants: coffee, cola, cigarettes, attention. And as much as he wants.  And perhaps even a bit more. We don’t do this to spoil him or because we only want to avoid problems; we do this to create peace and to be able to give him what he really needs: companionship, the relationship in which the person feels safe, loved, loving and engaged.

 

This doesn’t go over night. It’s a process which can take quite some time, because the person comes out of a situation where his predictable negative interactions with his caregivers went on for sometimes many years.

 

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